Assessment of Depressive and Anxiety Symptoms and Health-Related Quality of Life in Rosacea Patients: A Case-Control Study.

Background: Rosacea, a chronic facial dermatosis, poses a substantial global prevalence burden. Its impact extends beyond physical symptoms, affecting patient quality of life, self-esteem, and psychosocial functioning. This study aims to assess the health-related quality of life and emotional well-being in Jordanian rosacea patients in comparison to healthy controls. Methods: A case-control study, matching for age and sex, was conducted among rosacea patients attending the outpatient department at a governmental secondary hospital in the north of Jordan between September 2022 and November 2023. Adult patients with a confirmed rosacea diagnosis for a duration of ≥ 3 months were paired with healthy controls. Health-related quality of life, anxiety, and depression were evaluated using the Dermatology Life Quality Index (DLQI) and the Hospital Anxiety and Depression Scale (HADS), respectively. Disease severity was assessed using the Clinician's Erythema Assessment (CEA) grading system. Results: The study included 198 rosacea patients and 198 healthy controls. Rosacea patients exhibited significantly higher DLQI scores (mean 11.32 ± 5.4) compared to controls (mean 4.28 ± 2.3), indicating diminished quality of life. Subscale analysis revealed prominent differences in symptoms/feelings and daily activities. Additionally, rosacea patients reported elevated scores on the HADS anxiety (mean 9.38 ± 3.2) and depression (mean 8.19 ± 4.3) subscales in contrast to controls (mean 3.88 ± 2.18 and mean 3.41 ± 1.87, respectively). More than half (57%) of rosacea patients experienced moderate or severe anxiety, and nearly a third (31%) reported moderate or severe depression. Regression analyses revealed that higher disease severity significantly predicted worse quality of life (β = 0.384), anxiety (β = 0.352), and depression (β = 0.312). Conclusion: The study demonstrated that rosacea patients in Jordan experience significantly diminished quality of life and higher rates of anxiety and depression compared to healthy controls. Disease severity and multiple facial lesions emerged as strong predictors of poor psychological outcomes, while female gender increased vulnerability and longer disease duration showed a protective effect. These findings emphasize the need for routine psychological screening and a holistic treatment approach, particularly for newly diagnosed patients with severe disease manifestations.